Trigeminal trophic syndrome (TTS) is a rare condition characterized by cutaneous ulceration in the distribution of the trigeminal nerve, most commonly the infraorbital nerve, due to self-inflicted trauma from facial dysesthesia. It results from damage to the trigeminal nerve pathway from various etiologies like iatrogenic nerve injury, cerebrovascular disease, or malignancy. Clinically, patients present with trigeminal anesthesia, facial paresthesia, and crescent-shaped nasal ulcers. Treatment is multidisciplinary and includes behavioral modification, neurologic evaluation, pain management, and various medical therapies.